A quasiexperimental study to assess the perception of pain in infants after intramuscular vaccination

Abstract

Background: Intramuscular (IM) vaccination injections are an important cause of iatrogenic pain. Nonpharmacological intervention helps to reduce pain perception during immunization. Purpose: To compare the pain perception during IM injection, among infants who were breastfed versus local cold application in the vaccination clinic of a tertiary referral center. Materials and Methods: This study was conducted in the immunization clinic of a tertiary center. 60 infants (30 each in the intervention and control group) were selected for the study using simple random sampling method. Demographic proforma, Face, Legs, Activity, Cry, and Consolability (FLACC) pain scale was used to collect data of infants aged of 0–6 months. One group was breastfed and the other group local cold application was applied before the IM vaccine. Infant pain was assessed using the Modified FLACC Pain Scale. Results: Majority of the infants (36.6%) perceived moderate pain when the injection was given after local cold application, whereas least (23.3%) demonstrated moderate pain when the injection was administered after breastfeeding. The median score of infants in the local cold application group (5.5) was greater than that of the breastfeeding group (4.0). Conclusion: The study concluded that the application of cold can be used to reduce pain during IM vaccination in children <6 months of age where breastfeeding is not possible.